Breaking Down Medicare’s Proposed Decision on Aducanumab and Monoclonal Antibody Treatments

On January 11, the Centers for Medicare and Medicaid Services (CMS) announced its much-anticipated coverage proposal for monoclonal antibody treatments that target amyloid for the treatment of Alzheimer’s disease. According to the proposed policy, this class of drugs, which includes aducanumab, also known by the brand name Aduhelm, would be covered for people with Medicare only if they are enrolled in qualifying clinical trials. Dr. Jason Karlawish joins the podcast to discuss the recent proposal, share his reaction to the decision, and tell us how this coverage policy could impact the development of other Alzheimer’s disease treatments in the future.

Guest: Jason Karlawish, MD, co-director, Penn Memory Center, professor of medicine, medical ethics and health policy, and neurology, University of Pennsylvania

Episode Topics

1:48 What’s the difference between the FDA and Centers for Medicare and Medicaid Services?

3:58 What is the purpose of sharing a proposal and allowing public comment after? Is it possible the proposal could change?

9:09 What are your key takeaways from the CMS proposal?

11:58 Who’s being charged the cost of the treatment if it is part of a clinical trial?

18:33 What does this decision, with its focus on research often occurring in major urban medical centers, mean for equity and access?

26:27 What is the future of Alzheimer’s disease research after the CMS decision?

Show Notes

Read the Center for Medicare and Medicaid Services’s press release about the proposed coverage policy, view submitted public comments about the decision, and submit your own comment.

Learn more about Dr. Jason Karlawish’s work and writing at his website.

Listen to our four-part episode series with Dr. Jason Karlawish about his book, The Problem of Alzheimer’s, on our website (episode 1, episode 2, episode 3, episode 4).